About



Improving ICU Experience


Type: Mixed Method (explorative + descriptive) Research
Project Duration: 1.5 months (Oct-Nov 2019)
Role: Design Researcher




Background
& Goal

The ICU is a very emotionally charged space that can result in traumatizing experiences for patients and visitors of patients alike. Additionally, caretakers and practitioners that navigate this space become so desensitized to the experience that it is difficult for them to empathize with the distressed visitors. 

In this project, our team aims to challenge the way medical professionals recognize and identify each patient to explore the way people build trust and understanding in the ICU environment and further suggest different ways to encourage patient-centered ICU experience.

Research Questions:
- How might we build trust and understanding between patients and ICU staff so that patients can focus on their recovery process?
- How might we encourage medical professionals to incorporate patient centered care in the ICU?




Team

Our team was a group of Brown and RISD students affiliated with Design For America: Sejin Hwang(Industrial Design), Jillian Cai(Industrial Design), Felicia Renelus(Cognitive Science), Claire Lin(Engineering), Gabby Hoefer(Computer Science)



Method



Research Plan





Testing &
Analysis

Interview

To kick off, we interviewed 5 patients/caregivers and 9 ICU staffs (physicians and nurses). For patients and caregivers, we aimed to understand their general thoughts on ICU experience. Therefore, we focused on asking how patients and caregivers describe their experience and struggle in ICU, especially related to the interactions with staffs. For healthcare professionals, we wanted to understand how staffs recognize patients’ struggle and situation in ICU environment.



Key findings from thematic analysis
1. Involvement of patient/family is important in patient-staff interaction: staffs think that giving families some type of control in a patient situation or involving them in the decision-making process is important in building trust and creating better relationships between patient/family and staff.
2. Social worker intervention: there are certain situations in that patients, families and staff feel uncomfortable encountering each other. In these cases, social workers intervene in their interactions to support both sides.
3. Communication as a major challenge: staffs reveal their struggles with communication, especially the one between staff members. Due to the high-stress environment with a hectic schedule, some communication could fall through the cracks.




Survey

While having interviews, we created online survey to hear more from patients/caregivers. The major purpose of the survey was to understand which stage of ICU experience that patients/caregivers struggle the most and what are some improvements they are expecting. To help participants answer easily, we provided simple patient journey graphics that divided ICU experience into 4 stages (check-in, assessment, treatment, outcome). By doing so, we were able to get more detailed answers from patients/caregivers which helped us define what to ask to ICU staffs in later phases.



 Key findings
1. Focus on assessment stageassessment stage(running tests and getting asked questions about condition) was the most challenging experience for patients.
2. Staff-patient interactions and patient resources are the key area to improve: patients/caregivers believe these are the need improvements to make in ICU - shorter waiting time, better communication between patients and staff, increase efficiency for patients in pain, more sympathetic staffs, better acommodations for caregivers.




Shadowing 

During shadowing, our team wished to explore the realistic ICU environment and better understand the general workflow and human interactions. Based on the interview and survey data, we decided to focus on three areas during shadowing:
1) interactions between people
2) layout of the space 




Key findings
1. Nurses as key stakeholder in staff-patient interactionnurses have a broad range of communication including empathetic interactions with patients and caregivers. However, due to patients’ health conditions, most of the communication happened between nurses and caregivers.
2. Lack of communication between nurses and doctors: Due to hectic work shift of nurses, there isn’t enough time for doctors to interact with nurses. They usually communicate through the in
formation on the computers.




Participatory Workshop

From the survey data, we found that patients/caregivers wish for more sympathy from staff. However, when asking staff about empathy towards patients during the interview, interviewees were tend to be defensive so that we couldn’t get much data on topic of empathy. Therefore, we conducted a participatory workshop to learn about how staff recognize patients and also co-design various solutions for patient struggles.



Key findings from affinity diagram
1. Sensory overload: overload of stimuli during the stay was the major concern that staffs wish to improve for a better ICU experience of patients and their families.
2. Waiting time is the stage to intervene with design solutions: staffs believe that there are a lot of elements to improve while patients are waiting. For patients/families, providing tools to inform them about patient situations better, allowing patients to feel cared. For staff, creating tools that could reduce tedious responsibilities required in the primary stage to have efficient time managing for patient treatment.



Results







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